Urgent Care: The Beginning and End of the Acute Care Continuum

Gail Silver , MD

Associate Vice President of Ambulatory and Urgent Care Practice

Published May 16, 2012

We are beginning to see changes in healthcare delivery in the United States as the Healthcare Reform Bill is implemented. As anticipated, there is tremendous interest nationally in understanding and strategizing how to provide access to care for all Americans, and to deliver that care in an efficient and cost effective manner. While one of the stated goals of the Healthcare Reform Bill is that every patient should have a ‘Medical Home’, the projected shortage of primary care physicians will make the attainment of that goal a distant hope, rather than an imminent reality. Urgent Care Centers (UCCs) are starting to proliferate as health care delivery systems begin to respond to that need.

UCCs can help fill the access gap for patients whose conditions do not require the level of care provided by Emergency Departments. UCCs provide expanded hours, walk-in care that often includes many primary care services in addition to treatment for minor emergencies and acute illnesses. Many UCCs have on-site x-ray capability and point-of-care lab testing. Many also offer immunizations, sports physicals, pre-employment physicals, immigration physicals, as well as care for injured workers.

UCCs can serve as a resource to ensure that patients who have been hospitalized or discharged from the ED can get necessary follow-up and further outpatient evaluation in a timely manner. This role as the outpatient interface with the ED and the hospital is a critical piece of the Acute Care Continuum. Having a place that can provide guaranteed follow-up whenever it is needed can reduce hospitalizations for ED patients, length of stay for hospitalized patients and decrease the costs of care while maintaining patient safety and satisfaction.

The cost of care per patient for acute, but non-emergency conditions is lower in the UCC setting than it is in the ED, since the UCC does not need the diverse array of resources that are necessary in the hospital environment. This makes UCCs attractive to payers, patients and organizations responsible for managing patient care, such as ACOs.

As the US population increases, primary care shortages worsen and the nation’s emergency departments become increasingly crowded, alternative options for patients requiring acute care and follow up care are imperative. Urgent Care centers are one such alternative. They help close the loop from the outpatient setting to the ED or the inpatient setting and back to the post-hospital environment.

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